Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1043882103 Individual Practitioner Male Practitioner

Dr. Brock Wesley Nichols , DDS

Dentist • Shawnee, OK

Professional Overview & Biography Verified Profile Summary

Dr. Brock Nichols, DDS is a registered healthcare professional specializing in Dentist in Shawnee, OK. Practice services are available at 3703 N KICKAPOO AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3703 N Kickapoo Ave

Shawnee, OK 748041703

Telephone 4052750640
Fax 4052253008
Associated Practice Facility / Clinic
🏢 Summer Dental Shawnee Pllc Facility NPI 1548834872

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Shawnee, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 11.6 Yrs
Regional Practice Density
19 Specialists

Practicing in Shawnee, OK (1115 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-03-05
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License OK 7763

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License OR D11449

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Michael Bennett , DMD

Dentist - General Practice

NPI 1073258786

Doctor of Dental Medicine

Dr. Glenn Davis , DDS

Dentist - General Practice

NPI 1437198017

Doctor of Dental Surgery

Dr. Decker Lardner , DDS

Dentist - General Practice

NPI 1740112341

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location March 05, 2024

Registered at 3703 N KICKAPOO AVE, SHAWNEE, OK 748041703 (Tel: 4052750640)

📍
Updated Business Mailing Address March 05, 2024

Registered at 10041 OAKWOOD DR, EDMOND, OK 730255007 (Tel: 4054365583)

NPI Profile Active July 16, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location July 16, 2021

Registered at 20285 SW TUALATIN VALLEY HWY, ALOHA, OR 970032302 (Tel: 5033340930)

📍
Updated Business Mailing Address July 16, 2021

Registered at 22365 SW MANDAN DR, TUALATIN, OR 970627371 (Tel: 4054365583)

👤
Provider Name / Credentials Updated July 16, 2021

Recorded as BROCK NICHOLS, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 16, 2021

Dentist (License #D11449 in OR)

🟢
Initial NPI Registration & Enumeration July 16, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043882103
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 16, 2021
Last Update: March 05, 2024
Sole Proprietor: Yes

Mailing Address

10041 Oakwood Dr

Edmond, OK 730255007

Phone: 4054365583

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.